Anaphylaxis is a multisystem reaction to the release of histamine and other inflammation mediators by the mastocyte and basophile cells following stimulation of the body by an antigen such as a chemical, an insect bite, or a food item. The reaction can take different forms, such as cutaneous reactions erythema, pruritis, swelling , changes in the oral mucous membrane from changes in the voice to changes in the larynx , respiratory changes such as bronchial spasm , vascular changes hypotension, syncope, and collapse , and digestive changes nausea, vomiting, and diarrhea. Anaphylaxis is a condition that progresses rapidly to death. Barely 3 out of 10 individuals use EpiPens following severe anaphylactic reactions, and only 1 in 10 use EpiPens when symptoms appear. However, it should be noted that there have been no studies of the Twinject autoinjection device proving that the second dose consisting of a syringe containing adrenaline is easy to inject.
Call your healthcare provider right away if you have any of the following symptoms at an Twin epinephrine site: redness that does not go away, swelling, tenderness, or the area feels warm to the touch. Retrieved 8 Twin epinephrine The Globe and Mail. Take the used device with you to the emergency room or ask your doctor, pharmacist, or healthcare provider how to dispose of used injection devices safely. Twinject is designed as emergency supportive therapy only and is not a replacement or substitute for immediate medical care. Cash discount cards are not commercial payers and are not eligible to be used for this program. Gizmodo Media Group. Seek emergency medical attention after any use of epinephrine to treat a severe allergic reaction. If prolonged hypotension follows such measures, it may be Twin epinephrine to administer another pressor drug. Treatment of arrhythmias consists of administration of a beta-adrenergic blocking Raylene anal sex such as propranolol.
Redhead freckles masturbating. Why is this medication prescribed?
Rapid rises in blood pressure have produced cerebral hemorrhage, particularly in elderly patients with cardiovascular disease. Pharmaceutical Journal. Mylan 0. In the case of Intelliject, it is the generic drug in a new device. Epinephrine, when given intramuscularly or subcutaneously, has a rapid onset and Twin epinephrine duration of action. Retrieved 24 July Click to Read Notice. Look Electrical breast pumps the solution in the device from time to time. July 16, Suitable corrective measures Twin epinephrine be taken in such situations. The information about the drug itself is someone else's, but the applicant has to generate the data showing the drug works for the new indication.
Anaphylaxis can happen anywhere.
- Epinephrine injection is used along with emergency medical treatment to treat life-threatening allergic reactions caused by insect bites or stings, foods, medications, latex, and other causes.
- In an effort to help temporarily alleviate U.
- Medically reviewed by Drugs.
- Medically reviewed by Drugs.
An epinephrine autoinjector or adrenaline autoinjector is a medical device for injecting a measured dose or doses of epinephrine adrenaline by means of autoinjector technology.
The first epinephrine autoinjector was brought to market in the s. Epinephrine autoinjectors are hand-held devices carried by those who have severe allergies; the epinephrine delivered by the device is an emergency treatment for anaphylactic reaction. When anaphylaxis is suspected, epinephrine solution should be given as soon as possible as an intramuscular injection , in the middle of the outer side of the thigh, which corresponds to the location of the vastus lateralis muscle.
The epinephrine in autoinjectors expires after one year. The devices contain a fixed dose of epinephrine and a spring-loaded needle that exits the tip or edge of the device and penetrates the recipient's skin, to deliver the medication via intramuscular injection. People to whom epinephrine autoinjectors are prescribed need to be trained how to use the specific device prescribed. The European Medicines Agency conducted a review of the safety of devices then on the market and found several factors that determine whether the devices successfully deliver drug into muscle, including "needle length, the thickness of fat under the skin, the way the auto-injector works e.
Another design of epinephrine autoinjectors was created by two brothers who were also users of epinephrine autoinjectors. They realized the inconveniences of carrying bulky autoinjectors and decided to come up with a new device to address the problems while they were in college.
The brothers split to study different fields with a shared goal to create a new device. One brother took an engineering major and the other took a pre-medical track and earned a doctorate degree in pharmaceutical sciences.
Eventually, they came up with a design that has the shape and size of a smartphone which can be put into a pocket. The new device also has retractable needle and automated voice instructions to assist the users on how to correctly use the autoinjectors. The product was launched with the brand "Auvi-Q".
Autoinjectors were originally developed for the rapid administration of nerve gas antidotes in kits like the Mark I NAAK. The first modern epinephrine autoinjector, the EpiPen, was invented in the mids at Survival Technology in Bethesda , Maryland by Sheldon Kaplan   and was first approved for marketing by the FDA in In , Hollister-Stier received approval from the FDA to market an epinephrine autoinjector called Twinject that could deliver two shots of epinephrine, which it had spent ten years developing.
In , Mylan and King started marketing a new version of EpiPen with the same basic mechanism but a stronger spring, better safety features, and clearer markings and instructions; an expert for NBC News estimated that the cost to redesign the device and packaging may have been "several million dollars" and the cost to retool the manufacturing process may have "run into the double-digit millions. In , Intelliject, a US startup developing a new epinephrine autoinjector, licensed their product to Sanofi.
In , European regulators approved Twinject,  and also approved a new epinephrine autoinjector made by ALK and sold under the brand name Jext. Also in , Shionogi authorized Greenstone, the authorized generics division of Pfizer,   to begin selling an authorized generic of Adrenaclick.
In , Pfizer and King sued Intelliject and Sanofi after the companies filed a b 2  New Drug Application for the product, then known as "e-cue";  Pfizer, Mylan and Sanofi settled in under a deal that allowed the device to enter the market no earlier than November , pending FDA approval.
In , Mylan launched a program called EpiPen4Schools to sell EpiPens in bulk and with discounts to schools; to participate in the program schools had to agree not to buy epinephrine autoinjectors from any other company for a year. In December , the National Association of State Boards of Education launched a policy initiative designed to "help state boards of education as they develop student health policies regarding anaphylaxis and epinephrine auto-injector access and use," and advocated for state laws protecting school from legal liability for stocking and using epinephrine autoinjectors.
Gayle Conelly Manchin , mother of Mylan's CEO, Heather Bresch , had become president of the association in , and shortly after had discussed donations from her "daughter's company" to the association. Manchin had been appointed to the West Virginia state school board by her husband Joe Manchin , then-governor of the state, in In , Shionogi, the manufacturer of Adrenaclick and Twinject, announced it would stop making them;  it had sold the rights to the NDA to a company called Amedra Pharmaceuticals.
In June , Amedra relaunched Adrenaclick. In March , Impax Laboratories acquired the parent company of Amedra and Lineage, and placed Amedra and the Adrenaclick in its Impax Specialty Pharma division; at the same time it acquired Lineage, which it placed, along with its generic version of Adrenaclick, in its Impax Generics division.
In May , the Emerade epinephrine autoinjector developed by the Swedish company Medeca was approved in Sweden and Germany;  it had been approved in the UK in The agency warned Meridian Medical for failing to investigate problems with the devices, recall bad batches, and follow-up on problems found.
According to the FDA, the manufacturer of EpiPen devices failed to address known malfunctions in its auto-injectors even as hundreds of customer complaints rolled in and failures were linked to deaths. Sandoz, a division of Novartis , announced on July 9, the availability of Symjepi injection in 0. Community pharmacists were told to prioritise supplies for children weighing 25kg or less.
The EpiPen, manufactured by King, a subsidiary of Pfizer, and marketed by Mylan, has dominated the market. Mylan acquired the right to market the EpiPen line of epinephrine autoinjector devices from Merck KGaA as part of their deal. Mylan's efforts to maintain its market dominance were aided when Sanofi 's competing product was recalled in November and further when Teva 's generic competitor was rejected by the FDA in March In response to criticism, Mylan increased financial assistance available for some patients to purchase EpiPens,  a gesture that was called a "classic public relations move" by Harvard Medical School professor Aaron Kesselheim.
They do nothing about the high price which is still being paid by insurers, who ultimately pass the cost on to consumers. From Wikipedia, the free encyclopedia.
Epinephrine autoinjector Mylan 0. Play media. National Institute of Allergy and Infectious Diseases. April 23, Archived from the original on 4 May Retrieved 4 February Current Allergy and Asthma Reports. August Current Opinion in Allergy and Clinical Immunology. New York Times. Retrieved 6 March Petersburg Times. Archived from the original on February 1, Retrieved Amendment No.
Wall Street Journal. Retrieved 16 March Launch of Twinject for Anaphylaxis". Archived from the original on March 13, Tech firm: "It's the same core device " ".
NBC News. March 1, Archived from the original on June 30, Bloomberg News. Pharmacy Times. Archived from the original on August 29, Retrieved August 30, FDA via DailyMed. CBS MoneyWatch. July 16, The information about the drug itself is someone else's, but the applicant has to generate the data showing the drug works for the new indication.
In the case of Intelliject, it is the generic drug in a new device. For an explanation see Kenneth V. Retrieved 18 August PBS Newshour. USA Today. Magellan Medical. July Archived from the original PDF on September 9, US Government Dockets Repository. Retrieved September 10, Archived from the original PDF on And Lineage Therapeutics Inc.
Adis Insight. Retrieved 3 October UK Electronic Medicines Compendium. SEC Edgar. Richmond Times-Dispatch. Canadian Broadcasting Company. Richmond BizSense. Retrieved 19 August Retrieved 8 June September 6, Antitrust Probe". Retrieved September 7, The New York Times. Ars Technica.
Johnson August 25, It works by relaxing the muscles in the airways and tightening the blood vessels. Keep your automatic injection device with you or available at all times so that you will be able to inject epinephrine quickly when an allergic reaction begins. Ars Technica. The product was launched with the brand "Auvi-Q". Oxygen mask and Nasal cannula Oxygen concentrator Anaesthetic machine Relative analgesia machine. July
Twin epinephrine. What is epinephrine injection?
Epinephrine autoinjector - Wikipedia
Epinephrine injection is used along with emergency medical treatment to treat life-threatening allergic reactions caused by insect bites or stings, foods, medications, latex, and other causes. Epinephrine is in a class of medications called alpha- and beta-adrenergic agonists sympathomimetic agents.
It works by relaxing the muscles in the airways and tightening the blood vessels. Epinephrine injection comes as a prefilled automatic injection device containing a solution liquid and in vials to inject subcutaneously under the skin or intramuscularly into the muscle. It is usually injected as needed at the first sign of a serious allergic reaction.
Ask your doctor or pharmacist to show you and any of your caregivers who could be injecting the medication how to use the prefilled automatic injection device. Training devices are available to practice how to use the automatic injection device during an emergency.
Training devices do not contain medication and do not have a needle. Before you use epinephrine injection for the first time, read the patient information that comes with it. This information includes directions for how to use the prefilled automatic injection device. Be sure to ask your pharmacist or doctor if you or your caregivers have any questions about how to inject this medication. You should inject epinephrine injection as soon as you suspect that you may be experiencing a serious allergic reaction.
Signs of a serious allergic reaction include closing of the airways, wheezing, sneezing, hoarseness, hives, itching, swelling, skin redness, fast heartbeat, weak pulse, anxiety, confusion, stomach pain, losing control of urine or bowel movements, faintness, or loss of consciousness. Talk to your doctor about these symptoms and be sure you understand how to tell when you are having a serious allergic reaction and should inject epinephrine.
Keep your automatic injection device with you or available at all times so that you will be able to inject epinephrine quickly when an allergic reaction begins.
Be aware of the expiration date stamped on the device and replace the device when this date passes. Look at the solution in the device from time to time. If the solution is discolored or contains particles, call your doctor to get a new injection device. Epinephrine injection helps to treat serious allergic reactions but does not take the place of medical treatment.
Get emergency medical treatment immediately after you inject epinephrine. Rest quietly while you wait for emergency medical treatment. If your symptoms continue or return after the first injection, your doctor may tell you to use a second dose of epinephrine injection with a new injection device. Be sure that you know how to inject the second dose and how to tell whether you should inject a second dose. Epinephrine should be injected only in the middle of the outer side of the thigh, and can be injected through clothing if necessary in an emergency.
If you are injecting epinephrine to a young child who may move during the injection, hold their leg firmly in place and limit the child's movement before and during the injection. Do not inject epinephrine into the buttocks or any other part of your body such as fingers, hands, or feet or into a vein.
Do not put your thumb, fingers, or hand over the needle area of the automatic injection device. If epinephrine is accidently injected into these areas, get emergency medical treatment immediately.
After you inject a dose of epinephrine injection, some solution will remain in the injection device. This is normal and does not mean that you did not receive the full dose. Do not use the extra liquid; dispose of the remaining liquid and device properly. Take the used device with you to the emergency room or ask your doctor, pharmacist, or healthcare provider how to dispose of used injection devices safely.
Talk to your doctor about whether and when you should use epinephrine injection if you are pregnant. Keep this medication in the plastic carrying tube it came in, tightly closed, and out of reach of children.
Keep it at room temperature and away from light, excess heat and moisture not in the bathroom. Do not refrigerate epinephrine injection or leave it in your car, especially in hot or cold weather. If the prefilled automatic injection device is dropped, check to see if it is broken or leaking.
Dispose of any medication that is damaged or should otherwise not be used and be sure to have a replacement available. Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. It is important to keep all medication out of sight and reach of children as many containers such as weekly pill minders and those for eye drops, creams, patches, and inhalers are not child-resistant and young children can open them easily.
To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location — one that is up and away and out of their sight and reach.
In case of overdose, call the poison control helpline at If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at Do not let anyone else take your medication. If you use a prefilled automatic injection device, be sure to get a replacement right away. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription over-the-counter medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements.
You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies. Generic alternatives may be available. Epinephrine Injection pronounced as ep'' i nef' rin. Why is this medication prescribed? How should this medicine be used? Other uses for this medicine What special precautions should I follow?
What side effects can this medication cause? What should I know about storage and disposal of this medication? Brand names. Other uses for this medicine. What special precautions should I follow? Before using epinephrine injection, tell your doctor and pharmacist if you are allergic to epinephrine, any other medications, sulfites, or any of the other ingredients in epinephrine injection.
Your doctor may tell you to use epinephrine injection even if you are allergic to one of the ingredients because it is a life-saving medication. The epinephrine automatic injection device does not contain latex and is safe to use if you have a latex allergy. Be sure to mention any of the following: certain antidepressants such as amitriptyline, amoxapine, clomipramine Anafranil , desipramine Norpramin , doxepin Silenor , imipramine Tofranil , maprotiline, mirtazapine Remeron , nortriptyline Pamelor , protriptyline Vivactil , and trimipramine Surmontil ; antihistamines such as chlorpheniramine Chlor-Trimeton and diphenhydramine Benadryl ; beta blockers such as propranolol Hemangeol, Inderal LA, Innopran XL ; digoxin Lanoxicaps, Lanoxin ; diuretics 'water pills' ; ergot medications such as dihydroergotamine D.
Also tell your doctor if you are taking a monoamine oxidase inhibitor such as isocarboxazid Marplan , phenelzine Nardil , selegiline Eldepryl, Emsam, Zelapar , and tranylcypromine Parnate or have stopped taking it within the past two weeks.
Your doctor may need to monitor you carefully for side effects. Epinephrine injection may cause side effects. When you get emergency medical treatment after you inject epinephrine, tell your doctor if you are experiencing any of these side effects: skin redness, swelling, warmth, or tenderness at the site of injection difficulty breathing pounding, fast, or irregular heartbeat nausea vomiting sweating dizziness nervousness, anxiety, or restlessness weakness pale skin headache uncontrollable shaking of a part of your body.
Symptoms of overdose may include the following: sudden weakness or numbness on one side of the body sudden difficulty speaking slow or fast heart rate shortness of breath fast breathing confusion tiredness or weakness cold, pale skin decreased urination. What other information should I know?
Keep all appointments with your doctor. Browse Drugs and Medicines.